Organization
GULF COAST YOUTH SERVICES
Active
Other names
Okaloosa Youth Academy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY KAPLAN (CEO)
(850) 863-4160
Entity
Organization
Contact information
Practice address
4455 STRAIGHT LINE RD, CRESTVIEW, FL 32539-6720
(850) 863-4160
Mailing address
4455 STRAIGHT LINE RD, CRESTVIEW, FL 32539-6720
(850) 863-4160
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
260390701652
FL
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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